Healthcare Provider Details

I. General information

NPI: 1255606430
Provider Name (Legal Business Name): GARRETT WILLIAM FLEMING D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LANGWORTHY ST
DUBUQUE IA
52001-7313
US

IV. Provider business mailing address

123 HOSPITAL DR STE 2000
WATERTOWN WI
53098-3320
US

V. Phone/Fax

Practice location:
  • Phone: 563-584-3450
  • Fax: 563-584-3171
Mailing address:
  • Phone: 563-584-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO-05037
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: